Refund request form - Wayne State University

Fields with asterisks (*) are required.

DO NOT USE THIS FORM TO CANCEL YOUR SEMESTER PARKING PASS OR PAYROLL DEDUCTIONS. COMPLETE THE PARKING CANCELLATION FORM.

First name *

Last name *

Email *

Address line 1 *

Address line 2

City *

State/province/region *

Postal/zip code *

Country *

Phone Number *

ID # *

Campus location *

Occurrence date *

Occurrence time *

Refund amount requested *

***Refund Requests will be reviewed and staff will respond via email about any approved or denied requests.

Parking type

Parking w/cash

Parking w/OneCard

Parking w/credit card or debit card

If credit or debit card refund, indicate card number used (last 4 digits)

Refund type

Cash (deposit machine)

Printer/copier

Restaurant

Vending - Beverages (Note: For snack vending refunds do not fill out this form. Call 866-790-7088 to be refunded via Venmo)

Other

If other

Explanation for request